Is there an association between oral submucous fibrosis and ABO blood grouping?

BACKGROUND: Oral submucous fibrosis (OSMF) is one of the most common premalignant conditions in Indian subcontinent due to the traditional use of Areca nut and its various preparations. The genetic predisposition has also been reported in its etiopathogenesis. The rate of malignant transformation is between 7% to 14%. AIM: To evaluate whether ABO blood group is related to OSMF risk. SUBJECTS AND METHODS: It was a cross-sectional hospital-based study. A convenient sample of 164 study subjects constituted the cases and 180 subjects constituted the comparison group. STATISTICAL ANALYSIS USED: The results were analyzed using chi-square test and odds ratio. RESULTS: The chi-square analysis could not establish any significant relationship between OSMF and ABO blood group. But, when the strength of the association was measured using odds ratio, subjects with blood group A had 1.181 times higher risk of developing OSMF in comparison to other groups. CONCLUSION: The subjects with blood group A were at higher risk of developing OSMF in comparison to others. By performing blood group determination using a routine method at outreach programs, the susceptible individuals can be identified and counselled to quit the habit, thereby avoiding potential complications.

Evaluation of Musculoskeletal Disorders in Dentists and Application of DMAIC Technique to Improve the Ergonomics at Dental Clinics and Meta-Analysis of Literature.

INTRODUCTION: Musculoskeletal disorders (MSD) result in discomfort, pain and illness that can result in disruption or impairment of dental practice. MATERIALS AND METHODS: A cross-sectional study consisting of 60 dentists was carried out to determine musculoskeletal work related pain in major cities of Northern India. The study was planned in two phases. In the first phase, the subjects were given questionnaire related to the musculoskeletal pain happened over the last twelve months. In the second phase of study, improvement was carried out by recommending the subjects to implement ergonomics at their workplace. After three months subjects were again approached and given questionnaire about the musculoskeletal disorders. DMAIC (define, measure, analyse, improve and control) methodology of six sigma strategy was used to access the MSDs. Chi-square test was used for the analysis and a p-value of less than or equal to 0.05 was considered statistically significant. RESULTS: The overall prevalence of musculoskeletal problems in the present study was found to be 68.3%. After three months only 23 respondents applied ergonomics at their work place, prevalence of pain was reduced in neck from 47.8% to 21.7% out of total 23 respondents, shoulder pain 39.1% to 17.3%, pain in elbows from 26% to 21.7%, as well as in other locomotor organs. The p-value was significant with p <0.05. CONCLUSION: MSD represents a major occupational health issue for dentists in India as well as worldwide and result revealed necessitates the need of workshops to create awareness of ergonomics as effective measures for reducing MSD among dentists.

Concentration of Fluoride in Cow's and Buffalo's Milk in Relation to Varying Levels of Fluoride Concentration in Drinking Water of Mathura City in India- A Pilot Study.

AIM: To estimate fluoride concentration in drinking water, cow's milk and buffalo's milk and to correlate the concentration of fluoride in cow's milk and buffalo's milk with varying levels of fluoride concentration in drinking water. MATERIALS AND METHODS: Ten households having both cows and buffalo's were selected by convenience in each of the 3 zones (below optimum fluoride <0.7 ppm (parts per million), optimum fluoride 0.7-1.2 ppm and above optimum fluoride areas > 1.2 ppm). From these selected households, 200 ml of fresh milk of both cows and buffaloes was collected along with 200 ml of drinking water for estimation of fluoride concentration by using a fluoride ion selective electrode method. The data was analysed using SPSS, version 11.5 for windows. RESULTS: The mean fluoride concentration of drinking water, cow's milk and buffalo's milk in three different fluoride zones was 0.89±0.39, 0.09±0.07, 0.09±0.08 respectively. Pearson's correlation found a statistically significant correlation between fluoride concentrations in cow's and buffalo's milk with varying levels of fluoride concentration in drinking water in zone B and zone C. However, this correlation was not statistically significant in zone A. CONCLUSION: With an increase in fluoride concentration in drinking water there was an increase in concentration of fluoride in cow's and buffalo's milk. We conclude that this association is seen in conjunction to not only a single factor but rather due to culmination of several other aspects. So, there is a need to elucidate the other factors that might be contributing to this increase and dental fluorosis.

Drug-induced gingival overgrowth: the genetic dimension.

BACKGROUND: Currently, the etiology of drug-induced gingival overgrowth is not entirely understood but is clearly multifactorial. Phenytoin, one of the common drugs implicated in gingival enlargement, is metabolized mainly by cytochrome P450 (CYP)2C9 and partly by CYP2C19. The CYP2C9 and CYP2C19 genes are polymorphically expressed and most of the variants result in decreased metabolism of the respective substrates. AIMS: The present study was undertaken to investigate the influence of the CYP2C9*2 and *3 variant genotypes on phenytoin hydroxylation in subjects diagnosed with epilepsy from South India, thus establishing the genetic polymorphisms leading to its defective hydroxylation process. MATERIALS AND METHODS: Fifteen epileptic subjects, age 9 to 60 years were included in the study. Among the study subjects, 8 were males and 7 were females. Genomic DNA was extracted from patients' blood using Phenol-chloroform method and genotyping was done for CYP2C9 using customized TaqMan genotyping assays on a real time thermocycler, by allelic discrimination method. The genetic polymorphisms *1, *2 and *3 on CYP2C9 were selected based on their function and respective allele frequencies in Asian subcontinent among the Asian populations. RESULTS: CYP2C9*1*2 and CYP2C9*3/*3 were identified with equal frequency in the study population. There were seven subjects with CYP2C9*1/*2 genotype (heterozygous mutant), one subject with CYP2C9*1/*1 (wild type) and seven study subjects with CYP2C9*3/*3 (homozygous mutant). CONCLUSION: The results obtained in the present study will be helpful in the medical prescription purposes of phenytoin, and a more personalized patient approach with its administration can be advocated.

Association between use of tobacco and age on graying of hair.

AIMS AND OBJECTIVES: To determine the association between smoking, chewing tobacco (gutka), and age of individual on graying of hair. MATERIALS AND METHODS: The present study was conducted on 120 patients attending the Outpatient Department of the DJ College of Dental Sciences and Research, Modinagar, UP. The individuals were classified into four groups (group I, II, III, IV) on the basis of the form of tobacco use (smoking or chewing). The Pearson correlation coefficient was utilized to find the correlation between the mean percentage of individuals with gray hair, risk multiplication factor (RMF), and age of the individual. RESULTS: Mean percentage of individual with gray hair and RMF (r = 0.6487) are found to be positively associated. A significant and positive correlation was observed between the age of the individual and the frequency of individuals with gray hair. CONCLUSION: This study suggests that there is a significant association between tobacco use and aging on graying of hair.

A Clinical and Radiographic Evaluation of Periodontal Regenerative Potential of PerioGlas®: A Synthetic, Resorbable Material in Treating Periodontal Infrabony Defects.

BACKGROUND: Study of the clinical application of bioactive glass in treating periodontal defects has been gaining momentum. Studies in the past have hypothesized that bioactive glass resulted in an improvement of bony lesion when compared with open flap debridement. Considering that there were very few studies in the Indian dental literature involving the analysis of PerioGlas®- A particulate Bioglass in intrabony defects, the present clinical trial aimed to clinically and radiographically evaluate the efficacy of PerioGlas® and compare it to open debridement as control in the treatment of human periodontal osseous (three and two wall) defects in South Indian population. MATERIALS AND METHODS: Ten patients with chronic periodontitis within the age group of 30-45 years having at least two pockets with depth of ≥6 mm exhibiting vertical osseous defects were selected for the study. A total of 20 defect sites were randomly assigned to one of the two treatment modalities such that 10 sites (experimental) received PerioGlas® material after open flap debridement and 10 sites with open flap debridement (controls). Plaque index and gingival index (GI) were recorded at baseline, 6 weeks, 3 months, 6 months and 9 months, whereas probing pocket depth (PPD), clinical attachment level and gingival recession (GR) were recorded at baseline, 6 and 9 months postoperatively. Linear radiographic measurements were carried out at baseline, 6 and 9 months to evaluate the defect fill, defect resolution and change in the alveolar crest height (ACH). RESULTS: Both experimental and control site showed a significant reduction in plaque and GI, and a slight increase in GR. The mean reduction in PPD for experimental and control site was 4.4 ± 0.34 mm and 3.2 ± 0.1 mm, respectively. Gain in clinical attachment at experimental and control site was 4.4 ± 0.21 and 3.4 ± 0.11, respectively which on comparison was statistically non-significant for both sites. The radiographic mean defect fill for experimental site was 1.73 mm. The mean defect resolution was 46.5% and 15.3% for the experimental group and control group, respectively, with a slight increase in the ACH at the experimental site. CONCLUSION: Comparison of experimental and control sites revealed a statistically significant improvement in both clinical and radiographic parameters, but experimental sites showed better results when compared with control. How to cite the article: Chacko NL, Abraham S, Rao HN, Sridhar N, Moon N, Barde DH. A clinical and radiographic evaluation of periodontal regenerative potential of PerioGlas®: A synthetic, resorbable material in treating periodontal infrabony defects. J Int Oral Health 2014;6(3):20-6.

Genetically altered fields in head and neck cancer and second field tumor.

The concept of field cancerization has been ever changing since its first description by Slaughter et al in 1953. Field cancerization explains the mechanisms by which second primary tumors (SPTs) develop. SPTs are the tumors, which develop in the oral cavity in succession to the primary malignant tumors, which might vary in duration ranging from few months to years. Conceivably, a population of daughter cells with early genetic changes (without histopathology) remains in the organ, demonstrating the concept of field cancerization. This review explains the concept of field cancerization and various field theories along with molecular basis of field formation.

Granulocytic sarcoma in non-leukaemic child involving maxillary sinus with long term follow up: A rare case report.

Granulocytic sarcoma (GS) is a rare extramedullary malignant tumor composed of immature myeloid cells. It is strongly associated with acute myeloid leukaemia, chronic myeloproliferative diseases. Occurrence of GS in the oral cavity is extremely uncommon. Present case reported an unusual occurrence of GS without leukemia involving maxillary sinus of a child. The patient underwent chemotherapy followed by radiotherapy with complete remission. A long-term follow-up of the patient was carried without any evidence of recurrence with special focus on diagnostic difficulties. The present case highlights the perplexity in diagnosing such lesions with emphasis on the need of careful interpretation of all clinical, radiographic, histopathological and immunohistochemical details as it is one of the most frequently misdiagnosed disorder.

Unusual length of pedicle: pedunculated squamous papilloma of uvula causing unusual Dysphagia of long duration in a child of 10 years.

Benign oropharyngeal tumors are far less common compared to malignant tumors. Oropharyngeal papilloma is present in adults. Squamous papillomas are exophytic masses of oral cavity. When they occur on the palate they are most often asymptomatic and benign. Pedunculated squamous papillomas usually arise from the soft palate, tonsil, or the epiglottis. These lesions can sometimes prove to be fatal. A case of pedunculated squamous papilloma, arising from the laryngopharynx, the clinical presentation, the site of origin, and the size of the lesion were quite unusual. The narrow base of the pedicle made the intraoral excision possible. But here, we present a case of a 10-year-old boy who had history of dysphagia of 3-year duration for solid food and he was comfortable only in squatting position the reason being squamous papilloma of uvula (unusual site) atypically because of astonishing length of pedicle (2.3 inches).

Arteriovenous malformation of the oral cavity.

Vascular anomalies are a heterogeneous group of congenital blood vessel disorders more typically referred to as birthmarks. Subcategorized into vascular tumors and malformations, each anomaly is characterized by specific morphology, pathophysiology, clinical behavior, and management approach. Hemangiomas are the most common vascular tumors. Lymphatic, capillary, venous, and arteriovenous malformations make up the majority of vascular malformations. Arteriovenous malformation of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent a lethal benign disease. Here we present a case report of a 25-year-old male patient with arteriovenous malformation involving the base of tongue.

A comparison of oral hygiene status and dental caries experience among institutionalized visually impaired and hearing impaired children of age between 7 and 17 years in central India.

AIM: The aim of this study is to compare the oral hygiene status and dental caries experience among institutionalized visually impaired and hearing impaired children of age between 7 and 17 years in Bhopal city of Madhya Pradesh located in Central India. MATERIALS AND METHODS: A total of 95 hearing impaired and 48 visually impaired children of age between 7 and 17 years were recruited from special care institutions (one institution of hearing impaired and two institutions of visually impaired) in Bhopal city. Information related to different study variables was obtained from both groups. Oral hygiene index simplified (OHI[S]), decayed,extracted, filled teeth (deft and DECAYED, MISSING, FILLED TETTH (DMFT)) indices were used to record the oral hygiene status and dental caries experience. RESULTS: Mean OHI(S) score for hearing impaired was 1.15 ± 0.72 while it was 1.51 ± 0.93 for visually impaired children (P < 0.05). Mean DMFT score was 1.4 ± 1.95 and 0.94 ± 1.45 among hearing impaired and visually impaired respectively. The hearing impaired had a mean deft score of 0.47 ± 1.01 and in visually impaired it was 0.19 ± 0.79 and the difference was statistically significant (P < 0.05). CONCLUSION: Oral hygiene status of hearing impaired children was better than visually impaired and the difference was statistically significant. There was no significant difference between both groups with respect to DMFT. The hearing impaired children had significantly higher deft than visually impaired.

The use of controlled release locally delivered 10% doxycycline hyclate gel as an adjunct to scaling and root planing in the treatment of chronic periodontitis: clinical and microbiological results.

BACKGROUND: Local delivery of antimicrobial agents provides higher concentration of the drug in the periodontal site for longer periods than systemically delivered methods. In the present study an attempt is made to know the efficacy of controlled local drug delivery of doxycycline as an adjunctive treatment in the management of chronic periodontitis. MATERIALS AND METHODS: A total of 12 patients, diagnosed as Chronic Periodontitis in the age of 25 to 55 years, were selected of both the sexes in this study. They were divided into Experimental group consisted of 30 sites who received complete scaling and root planing (SRP) followed by placement of Atridox gel and control group consisted of 30 sites who received only SRP. Clinical parameters were recorded at, baseline, days 30, 90 and 180. Parameters were plaque index, gingival index, gingival bleeding index and microbial analysis, probing pocket depth and Clinical attachment level (CAL). The microbiological analysis was done at baseline visit and at 90th day. Probing pocket depth and CAL were recorded only on day 0 and 180th day. RESULTS: In 180 days study, both the groups exhibited a significant improvement in periodontal status. Significant gain in attachment level was observed in both the group. Between both the groups the clinical parameters in the experimental groups exhibited better results as compared to the control group. Both the groups exhibited significant reduction in the number of spirochetes. CONCLUSION: Combination therapy of SRP and 10% DH gel demonstrated better results at all levels suggesting that this therapy can play a significant role as an adjunct to SRP in the management of chronic periodontitis.